Dr. Wei Lan is a Consultant Pain Physician
Epidural Steroid Injection Information
What is an Epidural Steroid Injection?
An epidural is an injection that delivers an anti-inflammatory medication (steroid) directly into the epidural space in the spine. Sometimes, a low dose of local anaesthetic is also given.
Why has an epidural been recommended?
An epidural steroid injection is a non-surgical treatment, mostly done to help relieve back and leg pain(sciatica) caused by a variety of conditions such as spinal stenosis, spondylolysis, or disc herniation. It can also be used for neck pain. It can be a very useful alternative to surgery for some people.
How do they work?
Very often, pain is caused by irritation of the nerves supplying the back and legs. Epidurals work by delivering steroids directly to the nerves which are irritated. The aim is to reduce inflammation in these nerves and thus help with your pain.
When can an Epidural Steroid Injection not be given?
Because an epidural injection is done under X-Ray guidance, you cannot have it if you are pregnant, as it could damage your baby. You must be 100% certain that there is no possibility of pregnancy when coming in for procedure. Also, if you have an infection, burn or open wound of any kind, have recently had surgery or the flu vaccine or have very high blood sugars or blood pressure your procedure may be cancelled. If you are on blood thinners of any kind you must discuss this with the Pain Doctor, well in advance of your procedure date.
What can I expect after an Epidural Steroid Injection?
An epidural injection is being performed with the aim of reducing your pain and your symptoms and also, to hopefully, provide a window for some rehabilitation work such as physiotherapy/exercise.
Although how effective the injection will be for you cannot be determined in advance, many people will have some noticeable improvements in symptoms. Generally, it takes 1-2 weeks for the injection/injections to begin to work. Effects can last for weeks or months or sometimes years.
Are there side effects/complications? (Please discuss any concerns with your Doctor.)
Epidural steroid injection has a long history of safe use. However, like any medical procedure, there is a possibility of side effects/complications and you need to be aware of those.
Side effects include: Headache (usually gets better within a few days).; low blood pressure (settles very quickly);Infection and Bleeding (rare); nerve damage (very rare); Allergic Reaction(rare). High doses of steroids can also have side effects so repeat injections need to be spaced out.
*If your injection also included some local anaesthetics, you may have some numbness and weakness in the affected area for up to 24 hours – you need to be extremely careful when mobilizing, particularly on the day of your procedure (but caution is advised for up to 24 hours).
When can I resume normal activities/medications?
When the pain is improved and with the approval of your doctor, we very much encourage you to start regular exercise and activities as this will help with your overall pain management and mood – Remember, to do so in moderation and to increase activities and exercise gradually.
Activity:
Procedure Day: You are advised to rest on the day of your procedure.
Day2: Return to 25% to 50% of your usual activity level (*follow instructions above if local anaesthetic given).
Day 3: Return to 50% to 75% of your usual activity level.
After that, you can resume your normal activities as tolerated.
Medication:
Continue to take your usual pain medication until you notice some improvement in symptoms. Link in with your GP with regards to any medication changes.
Resume anti-coagulants the first day after the injection or follow your doctor’s specific advice.